President's Student Emergency Fund Application
Please review eligibility requirements and additional information at https://www.hcc.edu/alumni-and-friends/the-hcc-foundation/presidents-student-emergency-fund.
Student Name *
Your answer
Date of Birth *
MM
/
DD
/
YYYY
Phone Number *
Your answer
Email *
Your answer
Please provide a brief statement explaining why you are requesting emergency funding. *
Your answer
Please list the expense(s) and amount(s) for which you are requesting assistance. *
Your answer
Please provide a brief explanation of your financial circumstances, and describe your efforts to obtain funds and/or support through other sources. *
Your answer
If applicable, please provide the name and contact information for the provider/vendor to whom funds may be directly distributed. (For example: funding for temporary rent will be paid directly to landlord.)
Your answer
Student Certification
By submitting this form, I certify that:

● The information is complete and accurate.
● I will use Student Emergency funds only for the purpose(s) specified.
● I will submit receipts or other documentation as requested.
● I am aware that although it is not HCC’s policy to reduce financial aid awards when a student receives a private subsidy, there are limited occasions when the college is required by regulations to make adjustments. Whenever possible, any necessary adjustment is made by reducing student loan awards. I understand that accepting this subsidy could require the school to make an adjustment to my financial aid. (Please consult the Financial Aid Office to determine if your grant or loan will be affected.)

Students will receive an acknowledgment by email, typically within 1 business day, with information about any next
steps. Once an application for funding has been approved, every effort will be made to provide the student with funding within 3 business days.

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